Childhood trauma and increased stress sensitivity in psychosis

Objective: The notion that traumatic experiences in childhood may predict later psychotic outcomes would be strengthened if a plausible mechanism could be demonstrated. Because increased stress sensitivity is part of the behavioural expression of psychosis liability, the possible mediating role of childhood trauma was investigated. Method: Fifty patients with psychosis were studied with the experience sampling method to assess stress reactivity in daily life, defined as emotional and psychotic reactivity to stress. Traumatic experiences in childhood were assessed with the Childhood Trauma Questionnaire. Results: A significant interaction was found between stress and CT on both negative affect (event stress: beta = 0.04, P < 0.04; activity stress: beta = 0.12, P < 0.001) and psychotic intensity (event stress: beta = 0.06, P < 0.001; activity stress: beta = 0.11, P < 0.001), showing that a history of CT is associated with increased sensitivity to stress. Conclusion: A history of childhood trauma in patients with psychosis is associated with increased stress reactivity later in life, suggestive for an underlying process of behavioural sensitization.